FDA Adverse Event Injury Summary report: N

11.0MM TI HELICAL BLADE 95MM

MDR report key: 2062603 · Received April 8, 2011

Report

Report Number
3003506883-2011-00012
Event Type
Injury
Date Received
April 8, 2011
Date of Event
September 15, 2010
Report Date
March 29, 2011
Manufacturer
SYNTHES ELMIRA
Product Code
HSB
PMA / PMN Number
K011857
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUBJECT DEVICE HAS BEEN RECEIVED AND IS CURRENTLY IN THE EVAL PROCESS.

Description of Event or Problem · 1

PT IMPLANTED WITH 11MM CANNULATED TROCHANTERIC FIXATION NAIL FOR A LEFT SUBTROCHANTERIC FEMUR FRACTURE ON (B)(6) 2010. F/U X-RAYS 90 DAYS POST OP SHOWED THE NAIL TO BE BROKEN AT THE HELICAL BLADE/NAIL JUNCTION. NAIL WAS REMOVED ON (B)(6) 2010 AND PT REVISED TO ANOTHER INTRAMEDULLARY DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 11.0MM TI HELICAL BLADE 95MM HELICAL BLADE HSB SYNTHES ELMIRA NA 6381800

Patients

Seq Age Sex Outcome Treatment
1 58 YR Required Intervention NAIL